An ENT at St. Vincent’s One Nineteen answers your seasonal questions

Story by Dr. Kristopher Lay

Photograph contributed

Believe it or not, we’re already entering Alabama’s allergy season. Since many Birmingham-area plants start pollinating this month, when colds are common, my patients often ask the questions below in February. Perhaps my answers might help others dealing with similar symptoms.

How can I know whether I have a cold or an allergy?

As a physician specializing in otolaryngology (Ear-Nose-Throat/ENT) I can usually determine when people are infectious and when they have allergy symptoms. But, it’s often hard for patients to differentiate. Both will give you a sore throat, congestion, runny nose and even body aches, since both are inflammatory responses. Some patients report itchy throats and eyes with colds or allergies.

Since colds often don’t include fever, the best differentiator may be the time frame. Most colds last seven to 10 days. If symptoms last two weeks or more, you’re probably dealing with more than a cold.

When should I see a doctor?

Since chronic congestion from colds or allergies can lead to sinus infections, you should probably see a doctor if you’ve had symptoms for more than two weeks. ENTs actually got into treating allergies because patients were developing chronic or acute sinus infections. Doctors needed to learn to treat the underlying allergies to get them over the infections.

Another reason for a child to see a doctor is if they develop a hacking, dry cough. That can be a manifestation of asthma. Although they might not wheeze or complain, you should make sure they don’t need an inhaler to treat tight bronchial tubes.

What type of doctor should I see?

Most primary care doctors are really good at differentiating and treating colds and allergies. It’s appropriate to see your primary care doctor within the first two weeks of symptoms. An ENT typically comes into play later, if things aren’t getting better after that treatment.

People who have sinus infections several times a year might want to see an ENT to check for anatomical problems, such as a deviated septum. There may be surgical options they will want to explore.

Can I treat myself with over-the-counter (OTC) allergy medications?

Many people treat their allergies with OTC medications. Almost all antihistamines and intranasal steroids are now available that way, and are very safe, even when taken year-round.

Some patients develop medication intolerance, or find their medications becoming less effective or inconvenient. That’s when many seek allergy testing, opting for shots or sublingual drops for better symptom control.

To learn more about the full range of services at St. Vincent’s One Nineteen, visit

Dr. Kristopher Lay is an otolaryngologist (ENT) at St. Vincent’s One Nineteen.